Dr Amanda with straight smile Solutions straight smile solutions.com and today we're going to talk
a little bit more about elastics and how the biomechanics differ from using clear correct
or Invisalign or some type of clear liners versus braces so this is where I kind of get
back on my soapbox and I tell you you're never going to fully be able to master Invisalign
clear correct or clear aligners unless you understand braces in Phase One appliances
it's just how it is I have now been training doctors for a wow over 15 years but full time
for nine years General and pediatric dentist and it just kind of blows my mind the difference in
when I educate and work with doctors on their cases those that have first trained in Phase
One Embraces and then moved on to master liners versus those that are doing it backwards it just
doesn't work you guys don't get the concepts you just won't it's just like I mean it's like
I don't know I'm trying to think of an analogy but you know going to high school and having almost no
math background and trying to take calculus you're not gonna get it you know it's just
you think you get it but you won't get it so I'm just gonna keep saying you I don't care even if
you don't want to do it in your practice at least take the classes and understand the fundamentals
but you really really won't understand it unless you start doing it and that's just a fact but
anyways so I'm gonna talk to you high level on the whole how we use elastics in braces or let's
rephrase this how I use elastics and braces how I always train what works for me and then I'm going
to extrapolate that to aligners so with braces I mean first of all I've got tons and tons and
tons of videos in my Straight wire playlist and we are actually launching our streetwear course
and sometime in the next few weeks it's it's now November I'm hoping it will be launched
by December 1st and we will have some awesome promo pricing it will be on my website you will
do and if you're part of our newsletter you'll definitely know when it gets launched but anyways
um with braces we align and level first in our light night eye wires we do not close any space
in light night eye wires we do not use elastics okay class two and class three we will use
posterior box elastics for deep bites or for high canines light light ones in light nighttime wires
but basically for most patients you're not even getting into class 2 class 3 elastics until later
the second half of your treatment so that's after we've worked our way up after we've worked our
way through our twelves our 14s our 16s our 18s then we're probably not using all those wires but
um you know at least up to 18 night type passive taking a progress panel doing our repositions if
we need them which you shouldn't need to do if you're doing indirect bonding um and putting
your brackets on right to begin with and then we move our way up to the heavier nighttime
wires possibly steel sometimes yes sometimes no it depends on the situation and then come the class
two and class three elastics as needed remember elastics do not grow Jaws I can't say that enough
time they do not grow Jaws if you want to grow a jaw you have to use an appliance that grows a jaw
that means you have to use your Invisalign with Ma you you have to use a twin block you have to
use a binary you can use a forces you can use a Harps I'm not a big fan of those ladders just
because of the damage they can cause but anyways elastics tip teeth can't occlusal planes get teeth
to match up a little bit more and if there are spaces that have been created or exist if you
have the correct Anchorage Alaska's can help close the space in a positive direction to help make the
case class one if you're doing things properly that's how elastics work okay so and also if you
have impacted molars wisdom teeth elastics are not going to work as efficiently so it's always
a good idea to get those suckers out out before you use your class 2 class 3 elastics okay so
that's braces elastics in a nutshell for class two class three okay let's talk about aligners this is
the mistake I see so many of you guys throwing elastics on your cases I'm like why why why
why are you putting elastics on the case this is gonna do nothing all it's going to do is actually
make your case go worse and again this is my opinion because I've probably seen 10 20 30 40 50
000 aligner cases I don't even know it could be a hundred thousand a ridiculous amount I see dozens
a day you know for 20 years it adds up do the math I don't know maybe it's less but I sometimes see
more than a dozen today I see a ridiculous amount of aligner cases high level you know but I also
have the beauty of some a lot of my clients I'm with besides the cases I've done the clients I'm
with some of them five six seven eight nine long time some of them like I can't get rid of you guys
you're awesome you don't want to get rid of me so they just like to have me around just to see a
sample questions so I get to see these patients a couple years later and I feel even more confident
about my methods that they work so aligners treat them the same way you do braces don't throw pasta
I know you guys think that you're going to do one and done clinch acts but on a complicated
case that's class two or class three don't throw elastics on at the beginning occasionally I will
especially if I'm doing sequence a major sequential distillation case like a heroic
one we're talking like eight millimeters on the top or three millimeters on the bottom yeah I'm
gonna do elastics for Anchorage I mean the beauty of aligners is that you're you have
so much more control over your Anchorage so it's really really easy to do beads on the string and
slide those teeth one at a time backwards if you have a case like this let's say this
case was this I think this case actually is class three let's say we take these eights out the bone
heals a little bit and then we start scooting these suckers back one at a time one at a time
you don't really need the elastics to correct it but in braces you can't really do that so yeah
you need the elastic so you need a lot fewer elastics in Invisalign clear correct short
smile spark reveal I don't care Global whatever company you're using then you do and that's one
of the beauties of aligners is that you have so much more control over everything that's why I
love them so much especially on open bite cases especially on high angle cases I love a liner so
much more deep bite cases the few cases where I think braces work better a few situations
but it's it's getting to be less fewer and fewer where I think braces are superior to our liners
the vast majority I think aligners is faster healthier quicker better for the teeth better
for the gums than braces and you get a better outcome quicker in the right hands anyways so
no elastics and the other thing is you never ever ever want to hook the elastics onto the
plastic that's the dumbest thing ever all it does is affect the tracking okay it pulls you're trying
to keep this aligner always seated and engaged and then this is pulling it off it's a counter
Force why that makes no sense always use buttons always always always glue buttons on the teeth
if you're trying to do it elastics can count the occlusal plane so if you have a situation and you
got to think about this is why you have to take a ceph or at least A sagittal slice and these
type of AP sagittal cases where you're like okay it's a little class two it's a little class three
I'm just trying to get that last millimeter or two of jump the bite fix the bite last couple
millimeters okay think about how elastics work right if I'm starting out let's say a
Class 2 case let's say there's a Class 2 case that already has Pro kind upper incisors oh sorry class
two case that already has retroclined up burning sizers and proclined lower incisors oh my goodness
where to think about this for a second yes then the elastics are not going to do that much because
that's what the elastics would do they're going to go ahead and cant it in the direction that you're
doing it well that's not going to work but if I had a Class 2 case that had flared upper incisors
and retrocline lower incisors okay then that might work out that might be a good choice for elastics
and the opposite with class three right if I already have retrocline lower incisors right and
proclined upper incisors flared upper incisors there's no sense in using the class through
elastics it's not going to do anything it's not gonna unless you're creating space but if you're
creating space of the liners there it doesn't do anything anyways because I can just use my
sequential distillation or clinical mesialization to fix the bite so if you're not understanding
every little thing I'm saying then you're not ready to do take hard aligner cases and that's
what I'm getting at I'm talking kind of high level if you don't understand every single word of what
I'm saying you need to go back and do Braces 101 need to go back and do phase one Ortho 101
and then you're going to understand everything I'm saying and then your aligner cases will make sense
to you you'll be able to get excellent excellent outcomes and I just got to say it again if you do
not have a SEF machine you do not have a cbct that takes sagittal slices you got to have one or the
other if you're going to take hard aligner cases you're gonna have to sometimes take them and it's
not always at the beginning sometimes you're gonna have to take it in the middle you're checking on
something you know like what's going on this is weird let's take let's take a progress X-ray and
see what's going on we need to go take a progress sagittal slice let's see how those incisors are
what's going on what's Happening you gotta have a way to do that if you're going to take the harder
cases if you're going to punt all the higher cases no problem then I don't care as long
as your state doesn't require it and I don't memorize all the dental practice acts so all
right so anyways that was a big diatribe today hopefully you learned something new take care